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APHA Scientific Session and Event Listing

Jyotsna Jagai, MS, MPH¹, Anna Kosheleva, MS¹, Denise Castronovo, MS², and Elena Naumova, PhD¹. (1) Department of Public Health and Family Medicine, Tufts University, 136 Harrison Ave, Boston, MA 02111, 617-636-3852, jyotsna.jagai@tufts.edu, (2) Mapping Sustainability, Inc, 4324 Blowing Point Place, Jupiter, FL 33458

The incidence of Clostridium difficile associated diarrhea has risen over the past two decades and in the US more than 300,000 cases per year occur in hospitals or long-term care facilities. C. difficile is associated with antibiotic use and up to 75% of cases of antibiotic associated diarrhea are attributable to C. difficile. It is plausible that spatio-temproal patterns could be driven by pathogens for which antibiotics are prescribed. The presence of pathogens and their pathogenicity can be driven by environmental factors and may differ by climate zones. Therefore, we hypothesize that rates of C. difficile are associated with meteorological characteristics in different climate zones. All hospitalization records for C. difficile, as well as non-specific gastroenteritis infections and symptoms from the Centers for Medicare and Medicaid Services (CMS) MedPAR data file for a 5 year period (1998-2002) were abstracted. Annual rates were calculated for each county (3108) and each county was classified based on the Koppen Climate classification scheme and assigned to a watershed region. We compared the rates across climate categories and watersheds using ANOVA. The average annual county-specific hospitalization rate of C. difficile per 100,000 elderly was 234.59 ± 160.40 cases. The highest rates were seen in the humid climate region which covers the US Midwest (301.75 ± 182.34) and in the Ohio Region watershed (355.48 ± 167.94). Rates were also correlated with non-specific gastroenteritis (Pearson r = 0.345). These preliminary results suggest that higher rates of C. difficile are associated with climate-sensitive environmental characteristics.

Learning Objectives:

• Discuss how higher rates of Clostridium difficile are associated with climate-sensitive environmental characteristics.

Keywords: Emerging Diseases, Environment

Presenting author's disclosure statement:

Any relevant financial relationships? No